By Washington University School of Medicine, [RxPG] More than a decade after the first Gulf War in 1991, a detailed comparison of the health of veterans who were deployed to the Persian Gulf region and veterans who served elsewhere has found that the health of the two groups is very similar.

However, the study also found that Gulf War veterans are more likely to have chronic fatigue syndrome and fibromyalgia syndrome. The proportion of Gulf War veterans with these two illnesses is very small, according to lead author Seth Eisen, M.D., physician at the St. Louis Veterans Affairs (VA) Medical Center and professor of medicine and psychiatry at Washington University School of Medicine in St. Louis.

"But that doesn't mean these conditions aren't serious concerns for those veterans who still have them 10 years later," Eisen says. Fibromyalgia syndrome afflicts sufferers with persistent, widespread pain. Chronic fatigue syndrome leaves sufferers with a disabling loss of energy. Despite decades of awareness of both conditions, their causes remain unclear, and no definitive cure exists for either condition.

The study, funded by the Department of Veterans Affairs, appears in the June 7 issue of Annals of Internal Medicine. It was conducted at 16 VA medical centers across the nation over a period of approximately 3 years. For the study, researchers performed a detailed series of medical and psychiatric assessments on approximately 1100 veterans deployed to the Gulf War region and 1100 veterans who were not deployed in that war.

"In addition to a comprehensive standard medical examination, we arranged a series of very specialized tests based on areas of potential problems suggested by earlier studies of veterans," Eisen explains.

Based on their age, gender and racial characteristics, there were no significant differences between rates of chronic fatigue and fibromyalgia in the non-deployed veterans and in the general population. However, while 0.1 percent of non-deployed veterans met the criteria for chronic fatigue, 1.6 percent of the deployed veterans did.

"When statistically adjusted, that's a risk of chronic fatigue 40 times higher in the deployed veterans than in the non-deployed veterans, "Eisen says. "That's statistically very significant."

Similarly, while about 1.2 percent of the non-deployed veterans had fibromyalgia, a significantly higher 2 percent of deployed veterans had the persistent, diffuse pain that is characteristic of the disorder.

Although researchers have yet to give a formal medical definition to Gulf War syndrome, Eisen says the findings affirm that a very small percentage of Gulf War veterans are at increased risk of disabling long-term medical conditions.

Given that fibromyalgia and chronic fatigue can develop in non-veterans who have never even left their home city, let alone the country, scientists are unsure what factors in the Gulf War combat theater might explain the increased risk of these conditions in veterans.

"We also don't know of anything special in regard to how to treat Gulf War-deployed veterans with these syndromes compared to people who were never in the military," Eisen says. "Often the most important thing for someone who's not feeling well is to know that they have a medically recognized condition. And that their condition will not damage any of their vital organs."

Eisen notes that physicians often advise patients with these conditions to try to keep a physically active schedule. Research into the causes and treatments of both disorders is ongoing.

"Any research advances made in studying Gulf War veterans specifically are very likely to help individuals with these syndromes in the general community and vice-versa," Eisen says.

Other conditions with increased incidence in deployed veterans included upset stomach and skin rashes. Eisen and his coauthors are further analyzing the data they gathered on veterans and their family members.

The Gulf War study participating investigators. Gulf war veteran's health: medical evaluation of a U.S. cohort. Annals of Internal Medicine, June 7, 2005; 881-889.

This study was supported by funding from the Department of Veterans Affairs.

Washington University School of Medicine's full-time and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked third in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare.

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